Increasing the use of intensified management of diabetes: An education program for physicians

Traditionally, continuing medical education (CME) programs do not address the changes in the organization of a practice necessary to implement new care strategies. We developed a continuing medical education program that included a structured method, termed environmental optimizing, to help primary care physicians implement intensified management strategies for insulin‐requiring patients with diabetes mellitus. To evaluate this approach, 88 physicians and 126 of their non‐obese, insulin‐requiring patients were surveyed and interviewed pre‐program and at six and twelve months post‐program. The results suggest that this approach to CME resulted in a significant number of physicians adopting the program recommendations. Specifically, there was a significant increase in the use of: 1) multiple daily insulin regimens (p=.01), 2) a program‐specific “tracer” insulin regimen (p=.001), 3) the use of HbAl assays to adjust insulin (p<.05), diet and exercise regimens (p<.05), and 4) patients' self monitoring behavior (p<.01). The results of this study suggest that incorporating environmental optimizing into CME curricula may enhance the adoption of program recommendations.